【摘要】 目的:研究食管癌放疗后食管狭窄形成的影响因素。方法:62例原发性食管癌患者在2005年10月至2008年6月间接受了放疗或放化疗联合治疗。治疗后定期随访患者的食管钡餐造影,评价食管狭窄情况,计算狭窄率,观察食管狭窄峰值出现的时间。并对患者年龄、肿瘤的位置、T分期、肿瘤侵犯食管全周的比例(周在性)、纵轴长度、放疗剂量、化疗参与等因素与放疗后发生食管狭窄进行相关性分析。结果:在16个月的中位随访时间内,共有27例(43.5%)患者出现了中度以上(狭窄率>50%)的食管狭窄。食管狭窄出现的高峰时间在放疗后5～8个月之间。单因素分析提示T分期、肿瘤侵犯管壁的周在性及无化疗参与为狭窄发生的相关因素(P值分别为0.0177、<0.0001和0.0034)。多因素分析的结论是周在性与无化疗参与对放疗后食管狭窄有显著影响意义(P值分别为<0.001和0.0011)。结论:在放疗剂量为60Gy左右的前提下,肿瘤在管腔内的周在性与放疗后狭窄的形成呈正相关,化疗的参与可能会降低食管狭窄的形成,放疗剂量与狭窄形成的关系在本研究中未得到确切证实。更多还原

【Abstract】 Objective: To identify risk factors influencing the development of esophageal strictures in patients treated with radiotherapy for esophageal carcinoma. Methods: Between October 2005 and June 2008, a total of 62 patients who underwent radiotherapy or chemoradiotherapy treatment were retrospectively reviewed. In the post-treatment follow up, stricture rate was calculated on the barium image, and peak time of stricture formation was recorded. Influencing factors of developing esophageal stricture were analyzed statistically in terms of age, tumor location, T stage, roundness, longitudinal length, radiation dose and the inclusion of chemotherapy. Results: During the follow-up, 27 patients (43.5%) developed an obvious esophageal stricture (stricture rate >50%). The peak time of stricture development was between 5 and 8 months after radiotherapy. Univariate analysis revealed T stage, roundness and exclusion of chemotherapy as predictive high-risk factors of esophageal stricture formation after radiotherapy. (P values were 0.0177, <0.0001 and 0.0034, respectively). Multivariate analysis revealed roundness and exclusion of chemotherapy as significant predictive factors (P values were<0.001 and 0.0011, respectively). Conclusion: Given radiation dose around 60Gy, the roundness of the esophageal lumen is an independent factor in predicting post-radiotherapy stricture formation. Inclusion of chemotherapy probably lowers the risk of stricture development.更多还原